1003872516 NPI number — JOSEPH C SZEKELY MD

Table of content: JOSEPH C SZEKELY MD (NPI 1003872516)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003872516 NPI number — JOSEPH C SZEKELY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SZEKELY
Provider First Name:
JOSEPH
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003872516
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6210
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87499-6210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-609-2258
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
610 W PINON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-325-1123
Provider Business Practice Location Address Fax Number:
505-325-3054
Provider Enumeration Date:
04/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  20020347 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5678037 . This is a "LOVELACE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04552806 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: NM019A28 . This is a "BCBS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 75608 . This is a "PRESBYTERIAN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1427182682 . This is a "GRP NPI" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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